المؤلفون: Charles Fauvel, Olivier Raitiere, Athénaïs Boucly, Pascal De Groote, Sébastien Renard, Jeanne Bertona, Nicolas Lamblin, Elise Artaud-Macari, Catherine Viacroze, Dominique Schleifer, Stéphane Dominique, Jérémie Pichon, Xavier Jais, David Montani, Olivier Sitbon, Laurent Savale, Marc Humbert, Fabrice Bauer

المصدر: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. 41(12)

مصطلحات موضوعية: Pulmonary and Respiratory Medicine, Adult, Transplantation, Pulmonary Arterial Hypertension, Hypertension, Pulmonary, Middle Aged, Risk Assessment, Ventricular Function, Right, Humans, Surgery, Female, Familial Primary Pulmonary Hypertension, Cardiology and Cardiovascular Medicine, Aged, Retrospective Studies

الوصف: Although ventriculoarterial coupling is associated with better survival in pulmonary arterial hypertension (PAH), existing PAH risk assessment method has not considered echocardiographic criteria of right ventricular to pulmonary artery coupling. We aimed to test the prognostic value of the echocardiographic tricuspid annular plane systolic excursion/systolic pulmonary artery pressure (TAPSE/sPAP) ratio for noninvasive PAH risk assessment.We retrospectively studied a cohort of 659 incident PAH patients from 4 independent French PH centers (training cohort: n = 306, validation cohort n = 353) who underwent follow-up TAPSE/sPAP measurement in addition to previously validated noninvasive risk stratification variables. The primary composite outcome was 3-year all-cause mortality or lung transplantation from re-evaluation.Mean age was 55 ± 17 years-old with a majority of female (66%). The three main PAH causes were connective tissue disease (26%), idiopathic (24%) and porto-pulmonary (19%). The primary composite outcome occurred in 71 (23%) patients. Multivariable Cox regression analysis retained 3 noninvasive low-risk criteria as associated with the primary composite outcome: NYHA I-II (p = 0.001), NTproBNP300 ng/L or BNP50 ng/L (p = 0.004), and TAPSE/sPAP0.33 mm/mmHg (p = 0.004). The more the low-risk criteria achieved at follow-up, the better the event-free survival both in the training and validation cohort (log-rank p0.001). In the training cohort, the c-index for these 3 criteria, for COMPERA 2.0 and for the noninvasive French Pulmonary Hypertension Network method were 0.75, 95%CI(0.70-0.82), 0.72 95%CI(0.66-0.75), 0.71 95%CI(0.62-0.73), respectively.The 3 following dichotomized low-risk criteria: TAPSE/sPAP0.33 mm/mmHg, NYHA I-II and NTproBNP300 ng/L or BNP50 ng/L allow to identify low-risk PAH patients at follow-up.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f50643d6e8c60de32c20539aa9d242cd
https://pubmed.ncbi.nlm.nih.gov/36202691